On the cheap

20th December, 2002
The Birmingham News

Health care claims latest woes in corrections calamity

The allegations of poor medical care at Alabama's prisons for women make them sound more like concentration camps: Female inmates sometimes pull their own teeth, are denied cancer treatment, don't receive medicine for diabetes and psychiatric disorders, and live with untreated gynecological problems, according to new claims added to an ongoing federal lawsuit against the state.

"Serious medical problems are largely ignored until they present an emergency, such as uncontrolled bleeding, seizures or strokes," the lawsuit says.

If those allegations are anywhere close to true, state officials must be held accountable. Already, they have much to answer for in the suit, filed in August on behalf of inmates at Tutwiler Prison for Women in Wetumpka and two work release centers for women. U.S. District Judge Myron Thompson has ruled that the crowded, unsafe dorms are unconstitutional, and given the state until Dec. 30 to present a remedy plan.

The ruling shouldn't have surprised anyone. Tutwiler, built in the 1940s for a maximum of 364 inmates, houses triple its capacity with 1,000 inmates. It was also more violent than any men's prison this year, with almost 100 assaults. Inmates and officers have been beaten in the past year, and some have been slashed with razor blades.

On top of this comes the complaint adding Naphcare Inc. and MHM Correctional Services Inc. as defendants in the suit. Both are private, for-profit companies the state Department of Corrections contracts with to provide health care for inmates. Naphcare's medical care contract last year was for $29.5 million, while MHM cost the state $1.75 million for the first full year of a three-year mental health contract, according to a prison spokesman.

While that sounds like a lot of money, here's some perspective: Alabama is last in the nation in funding medical care for prisoners, as well as last in the nation on prison spending. Naphcare received the contract after the state negotiated lower costs. Originally, four companies bid $38 million to $46 million. Even at those amounts, Alabama still would have ranked 50th in health care spending.

Alabama is finding out the hard way, courtesy of a federal judge, that you get what you pay for and suffer the consequences if you're not paying enough to meet constitutional minimums for inmate care.

It's not as if this is a new problem. Alabama has underfunded its prisons for decades, and often has wound up in court because of it. Even now, the prison system is defending itself in state court for systemwide overcrowding. Montgomery Circuit Judge William Shashy has ordered the state to transfer state inmates from crowded county jails to state prisons within 30 days, even though there's nowhere to put them. The prison system has 27,000 inmates, twice the number it was designed to handle.

Judges are making it clear: The state has no choice but to solve the problems with overcrowding, understaffing and medical care, even if it takes significantly more money. These are prisons, not concentration camps.